Saturday, July 12, 2008

Songs For the Deaf

And he hath been given license to breathe songs of lost rage and furor to the ears of the closed. For it was true- Their ear pussies would never be rocked with his Gospel of Nursing Blasphemy.

I am licensed friends. The Nusring School Graduate possesses a License to Ill.
It feels good. This joy is pure, genuine. And the relief is like the sweet warm clouded breath of my baby boy when we snuggle. And when my wife joins we snuggle like Champions.

Right away my resolve to not respond to every little thing in the nursing world with anger was put to the test.
I was able to schedule an interview with the management of the unit I want to work for the day I got my license number. So arrived, hair freshly shorn, faced shaved to a crisp, my balls smelling finely of expensive ode de cologne, oh babies I was prepared.
The interview consisted of Unit Manager, Unit educator, Assistant Manager.

The unit manager started the assault kindly: "First off, you are a very attractive candidate. You are the most enthusiastic student we've ever met."
Nice. But from there, they voiced their concerns. Concerns strangely identical to my instructors blast of me right after the award and scholarship debacle.
"Cocky" "Loose Cannon" "You started here way too overconfident" "We don't think you can handle the criticism required to work in this unit" "You mean you aren't ACLS certified?" "Do you think you know more than a med-surge nurse?" (I got my license THAT FUCKING DAY. AT WHAT POINT BETWEEN 0600 AND 1130 WAS I TO ACCOMPLISH THE TWO DAY ACLS COURSE?)

Then I went really nutty and told them of my contemplation of being a CRNA. And the shit subsequently really hit the fan. I know how dumb it is to tell a SICU manager you want to be a CRNA. I know the risks, but I took it. I told her, (I totally stole a line from "HEAT") "I give you my word that I will be here for 2 to 3 years. I know you don't know me personally but my word means something. My word is good."
The manager said, "I've been burned many, many times". But I won't burn her. My word
is good. I hope it shone through. Then she said, "I already knew." And I said, "Yeah, but I told you." I know who told her, too. This CRNA who works at the hospital who promised me he wouldn't tell her and promptly told her.
They said a lot of shit to me, most of it not nice, not innapropriate but not nice. The only unit in the hospital that isn't begging me to come work for them and these managers treat me like I'm some nursing failure. I've never been called a "loose cannon" before. That was pretty cool.
Then the education manager went onto the floor and asked a friend mine what he thought about me (he's a RN). My friend said, "People think he's arrogant but he's not. He's just really enthusiastic." I owe him one. At least she asked. It shows intent right?

How arrogant am I? How cocky do I come across? More than your average nursing student that's for sure. Your average new grad won't take her eyes off the floor. In a perfect world, in a world where capitalism led to happiness and fairness and real live ethics I would have been a salesman. That's what I do. I sell things, anything. In nursing, I sell safe health care, I sell the idea that you should change your diet at home. I sell the idea that talking rumors about me the second you think I'm out of ear shot is off limits to you. I sell the idea that the patient needs stronger pain meds. I sell the idea that I can outwardly feel as good about myself, I can answer questions and address situations with as much confidence, arrogance, sarcasm as that strapping young socialite MD over there. Basically put: The Nursing school Graduate possesses a License to ILL doesn't know his place. I see the ridiculousness of treating a human being a certain way just because of their job title, educational resources, or race. It deeply alarms people because I threaten their consistency. Because maybe consistency in what to expect, good or bad, is better than uncertainty. That's the problem with growing up in chaos. It often makes more sense than violent social organization.

That's my problem. I don't buy into the hospital hegemony because I'm too immature and vane to accept the fact that the force of my determination and sheer will does not give you status or credibility. Let them talk shit, let them challenge me and let me learn my place.

And in time, I will put pictures to my liking on the wall.

Sunday, July 6, 2008

The Day I Tried To Live

Angry Male Nurse is dead.

I've been wanting to kill him for a while and I really wanted to do it after I got my R.N.
To give his assassination a little more Umph.

But really, waiting to kill him until I get my license defies the purpose of ending this facet of myself.

Finishing nursing school, studying for the NCLEX, taking the NCLEX, waiting A GODDAMN MONTH FOR RESULTS has been wonderfully cathartic (and thanks to nursing school I can't ever use the word in any context without thinking of a juicy enema) and has really given me an attitude adjustment that I've been needing for awhile.

I'm going to keep this entry relatively short because readers don't read insanely long posts and I feel like what I'm going to be writing about for the next few posts is important, that these entries will pertain to you and your practice and your outlook on the medical biz and why you are in it.

I don't know if I passed the NCLEX. I know everybody says that they feel like they failed, some people KNOW they failed the exam- I categorize myself in the KNOW group. Maybe I am wrong. Hopefully I passed. But what I struggled with during the exam were like the ridiculously basic questions. Priority of nursing interventions for non-critical situations, mundane situations , situations so basic I've never seen a nurse intervene in them. Like a muscle cramp at 3 am while the patient is at home or brain freeze after drinking too much cold beverage. Given 4 choices, all of them right, one of them really right. The exam was testing my ability for analytic thinking. I'm not an analytic thinker. I'm a mechanical thinker, a creative thinker, a process thinker, but not an analytical thinker. But I don't blame the NCLEX or anything. It is a right of passage, weeding out the poor test takers from the truly dense and unsafe, from the ones who struggle with English, from the ones who just think too much (me!). Don't read into a question-well I do. I love to. That's why I like nursing. I love the puzzle.

So right now I am a nursing school graduate, with an I.P. permit, but not an R.N. And I have no blogger name because the blogger I was was really starting to disgust me and hinder my learning about nursing. And ultimately I'm a baby in the nursing game and newborns shouldn't be cynical. Part of the real me was AMN, part of me wasn't. But that is not so much important. What is important are the lessons I have learned from 7+ years in the medical field, starting when I was 20, ending where I am now in my early 30's (took a few years to work in media and sales) with a wife and a baby and a fuckload of ambition, tired outrage, exhausted disbelief at human behavior, annoyed with my own human behavior. 7+ years of lessons that could have changed me into a different person in so many different directions. I'm sad because sometimes those lessons stuck but most times they did not and I have repeated the same self destructive behavior over and over again. I have mastered the root cause of all nasty behavior in a hospital, I have the impetus for the worst behavior thoroughly mapped out under the guise of protecting myself from it but all I've really done is draw a route on the map to direct myself from point A: Unlicensed asshole who has been observing everybody and the constantly changing work dynamic to point B: Licensed asshole who thinks he knows everything but doesn't really listen to anything anyone has to say because their role as "fucked up person" has a direct route leading straight to and from my wacked and exhausted mind.
There is something to be said for acknowledging political play, to knowing what manager is trying to get what from what supervisor but it is an endless movement of gossip and really has no bearing on the job I need to accomplish on a daily basis.

I have been in a bizarre survival mode from really old shit, the kind of shit that makes you are what you are from the way you were raised, the kind of shit your therapist loves to dissect, the kind of behavior that I observed in others that disgusted me but when I got down to it, when I really looked at myself, shamefaced I realized it was in me.

I finally had to "stop, collaborate, and listen". (That's right, I just utilized Vanilla Ice as a major reference point for great personal change and goddammit it felt good).

I am going lay down some hardcore Mea Culpa, some ultimate my bad's in the next few blog entries and try to recenter myself.

1) I don't like what I've become, I don't like my response to the stress of being a nurse, to the stress of life and I don't need an R.N. to add credibility to the gravitas and sincerity of my will to change.

2) I will not be tightly wrapped anymore, the possibility of really bad things happening are ever present and it is a terrible life to live in fear. As Saint Al Pacino said in one of the finest films made,"Heat":
Tone Loc: Man, I could get killed for telling you this.
Pacino: Yeah, well, you could get killed walking your doggie!

3) I will not talk shit about my coworkers anymore as a useless attempt to gain alliance with other coworkers I hope will protect me from my own bad behavior.

4) I will not talk shit about anyone regardless of how much shit they talk about me. And if they are speaking ill of me because I have done something out of protocol I will wise up and get back in protocol.

5) When a patient, another nurse, a doctor, a respiratory therapist, family member makes a negative comment about my personality that is true I will not take it to heart and I will not hate myself for the imperfection of my personality, or for the exposure of being human. I will not hold a grudge against said co-worker for pointing out a human flaw and attempting to exploit it for their momentary gain. I.E. co-worker saying "I think he over reacts when he gets a patient with PVC's-pretty goofy" I do get alarmed easily. When alarms are going off in the C.T.U. It's because I don't want my patient to go into v-tach and code while I'm staring at the monitor with my hands warming my balls. What matters is the quality of your job performance and the condition of your patients before and after your shift was over. Am I in protocol? Yes? Keep on.

To be an Angry Male Nurse is the saddest possible fate in the world for me. Because while adults often demonstrate less than adult behavior in any job, in any situation I do believe there is a disproportional amount of BS in our field compared to others. The possibility of perpetual exasperation looms over me. And I do believe some nurses do behave unprofessionally too much of the time, either for their lack of knowledge of what appropriate behavior is or because they are simply overwhelmed by the endless barrage of shit they are expected to assess, plan to handle, implement, and evaluate the outcome of their handling. This job is doable, it does not require bitterness and contempt to do it right.

In nursing school, I used to bug out so hard, completely trip that the bad nurses were a reflection of me, of what I was destined to become. I felt real humiliation at their behavior as if it reflected on me because I chose the same profession. But it does not. A bad nurse does not mean I am a bad nurse. A great nurse does not mean I am a great nurse. It's like going to the gym and thinking that your body is as lean and toned or in poor shape as the people at the gym around you. I let my own identity crisis smolder on my own anger. Control, for the most part, was taken away from the nursing students at my school which was at a teaching hospital. My nursing school was an experience that is outdated and incredibly useful at the same time. It was militaristic, brutal, and like the purpose of all nursing schools weaknesses were exposed in the hope that they would be removed from the individuals performance and personal and professional growth would occur.
I obsessed over the pleasure some instructors derived from the process. I got pissed and stewed about the instructors who didn't care about the process and just laid your fuck up on you passively, completely taking away your ability to be an individual and ended every criticism with "maybe you shouldn't be here." But they didn't just say it to me, they said it to everybody. I took it so fucking personally, I started a war with the school because I thought it was wrong but also because I handled this style of educational process so badly.

Stress. Anxiety. If you can grow and learn when the pressure is on then you can learn and grow happily for the rest of your life.

I grew up with some serious stressors. But who didn't? But fuck, stress does not have to be stressful. How do I explain it? I do not have to respond to every insult, impropriety, every failure of the bureaucracy with rage and anxiety and more stress. Guess what everybody? I'm pooped. And I should be after nursing school but not this pooped. But not this soul tired. Truthfully, I started nursing school moderately burnt out. Being an E.M.T. can suck really hard.
I owe it to myself to not start out as an R.N. burnt out. I need to change and I am happy and excited to do so.

Final thought for this post:
Every single person who has left a comment on my blog has reminded me, or should I say informed me that the reality of working as a nurse with all the bullshit and back stabbing and nuttiness is like nursing school but only worse. There is more at stake. Thanks to everybody who helped me understand that because you are right. And if I go into my career serving a dish made up of my previous mindset of fighting fuckedupness with more fuckedupness garnished with some rage and paranoia sprinkled on top I would not only be the poster child for burnout but I quite possibly might hurt a patient when my mind is sailing the seas of outrage.

I feel like I am giving something up here everybody. I feel like I am giving up the fight, that I am letting poorly behaving, burn to a crisp burnt out nurses, status quo win- BUT I AM NOT. I believe that quiet professionalism with politely firm boundaries is akin to nirvana. Well, at least in the safety of my home and at my desk it does.

Angry Male Nurse is no more. Good riddance.